@article{SpiegelhalderBaumeisterAlKamalyetal.2022, author = {Spiegelhalder, Kai and Baumeister, Harald and Al-Kamaly, Abdulwahab and Bader, Martina and Bauereiss, Natalie and Benz, Fee and Braun, Lina and Buntrock, Claudia and Burkhardt, Maike and Cuijpers, Pim and Domschke, Katharina and D{\"u}lsen, Patrick and Franke, Marvin and Frase, Lukas and Heber, Elena and Helm, Kathrin and Jentsch, Terry and Johann, Anna and K{\"u}chler, Ann-Marie and Kuhn, Michael and Lehr, Dirk and Maun, Andy and Morin, Charles M and Moshagen, Morten and Richter, Kneginja and Schiel, Julian and Simon, Laura and Spille, Lukas and Weeß, Hans-G{\"u}nter and Riemann, Dieter and Ebert, David Daniel}, title = {Comparative effectiveness of three versions of a stepped care model for insomnia differing in the amount of therapist support in internet-delivered treatment: study protocol for a pragmatic cluster randomised controlled trial (GET Sleep)}, series = {BMJ Open}, volume = {12}, journal = {BMJ Open}, number = {8}, publisher = {BMJ}, issn = {2044-6055}, doi = {10.1136/bmjopen-2021-058212}, pages = {11}, year = {2022}, abstract = {IntroductionIt is unclear how internet-delivered cognitive-behavioural therapy for insomnia (CBT-I) can be integrated into healthcare systems, and little is known about the optimal level of therapist guidance. The aim of this study is to investigate three different versions of a stepped care model for insomnia (IG1, IG2, IG3) versus treatment as usual (TAU). IG1, IG2 and IG3 rely on treatment by general practitioners (GPs) in the entry level and differ in the amount of guidance by e-coaches in internet-delivered CBT-I.Methods and analysisIn this randomised controlled trial, 4268 patients meeting International Classification of Diseases, Tenth Revision (ICD-10) criteria for insomnia will be recruited. The study will use cluster randomisation of GPs with an allocation ratio of 3:3:3:1 (IG1, IG2, IG3, TAU). In step 1 of the stepped care model, GPs will deliver psychoeducational treatment; in step 2, an internet-delivered CBT-I programme will be used; in step 3, GPs will refer patients to specialised treatment. Outcomes will be collected at baseline, and 4 weeks, 12 weeks and 6 months after baseline assessment. The primary outcome is insomnia severity at 6 months. An economic evaluation will be conducted and qualitative interviews will be used to explore barriers and facilitators of the stepped care model.Ethics and disseminationThe study protocol was approved by the Ethics Committee of the Medical Centre—University of Freiburg. The results of the study will be published irrespective of the outcome.Trial registration numberDRKS00021503.}, language = {en} } @article{FraseAckerCohrsetal.2019, author = {Frase, Lukas and Acker, Jens and Cohrs, Stefan and Danker-Hopfe, Heidi and Frohn, Corinna and G{\"o}der, Robert and Mauche, Nicole and Norra, Christine and Pollm{\"a}cher, Thomas and Richter, Kneginja and Riemann, Dieter and Schilling, Claudia and Weeß, Hans-G{\"u}nter and Wetter, Thomas C. and Nissen, Christoph}, title = {Empfehlungen zur Durchf{\"u}hrung einer Polygraphie oder Polysomnographie im Bereich Psychiatrie und Psychotherapie}, series = {Der Nervenarzt}, volume = {91}, journal = {Der Nervenarzt}, number = {9}, publisher = {Springer Science and Business Media LLC}, issn = {0028-2804}, doi = {10.1007/s00115-019-00855-2}, pages = {843 -- 853}, year = {2019}, abstract = {Ein- und Durchschlafst{\"o}rungen, nichterholsamer Schlaf oder erh{\"o}hte Tagesm{\"u}digkeit sind unspezifische Symptome von heute ca. 100 unterscheidbaren St{\"o}rungsbildern, die in der kommenden 11. Revision der Internationalen statistischen Klassifikation der Krankheiten (ICD-11) erstmals als eigenes Kapitel 7 „Schlaf-Wach-St{\"o}rungen" zusammengefasst werden. Mit Blick auf den Fachbereich Psychiatrie und Psychotherapie besteht ein bidirektionaler Zusammenhang zwischen Schlaf-Wach-St{\"o}rungen und psychischen Erkrankungen. Schlaf-Wach-St{\"o}rungen k{\"o}nnen einen unabh{\"a}ngigen Risikofaktor f{\"u}r das Entstehen einer psychischen Erkrankung darstellen und den Erkrankungsverlauf ung{\"u}nstig beeinflussen. Zudem k{\"o}nnen Schlaf-Wach-St{\"o}rungen einer psychischen Erkrankung auch als Fr{\"u}hsymptom vorausgehen und damit ein wichtiger Hinweis bei der Fr{\"u}herkennung sein. Zahlreiche Schlaf-Wach-St{\"o}rungen k{\"o}nnen anhand der Anamnese und {\"u}blicher klinischer Untersuchungen diagnostiziert werden. Bei spezielleren Fragestellungen k{\"o}nnen die Untersuchung in einem speziali-sierten Schlaflabor und die Behandlung in einem schlafmedizinischen Zentrum im Sinne einer gestuften Versorgung notwendig sein. Hier ist die Polysomnographie die wichtigste Untersuchungsmethode f{\"u}r die Differenzialdiagnostik, f{\"u}r deren Abrechnung {\"u}ber die Kostentr{\"a}ger heute in Deutschland jedoch keine gesetzliche Grundlage im Bereich neuro-psychiatrischer St{\"o}rungen besteht. Die vorliegende Arbeit fasst die aktuellen Leitlinien hinsichtlich der Kriterien f{\"u}r eine Untersuchung im Schlaflabor aus Sicht des Fachgebiets Psychiatrie und Psychotherapie zusammen und stellt daraus abgeleitet Forderungen f{\"u}r eine leitliniengerechte Diagnostik und Behandlung.}, language = {de} } @article{SpiegelhalderAckerBaumeisteretal.2020, author = {Spiegelhalder, Kai and Acker, Jens and Baumeister, Harald and B{\"u}ttner-Teleaga, Antje and Danker-Hopfe, Heidi and Ebert, David D. and Fietze, Ingo and Frase, Lukas and Klein, Sarah and Lehr, Dirk and Maun, Andy and Mertel, Isabella and Richter, Kneginja and Riemann, Dieter and Sauter, Cornelia and Schilling, Claudia and Schlarb, Angelika A. and Specht, Markus and Steinmetz, Lisa and Weeß, Hans G. and Cr{\"o}nlein, Tatjana}, title = {Digitale Behandlungsangebote f{\"u}r Insomnie - eine {\"U}bersichtsarbeit}, series = {Somnologie}, volume = {24}, journal = {Somnologie}, number = {2}, publisher = {Springer Science and Business Media LLC}, issn = {1432-9123}, doi = {10.1007/s11818-020-00238-9}, pages = {106 -- 114}, year = {2020}, abstract = {ZusammenfassungDigital angebotene psychologische Interventionen gegen Schlafst{\"o}rungen sind aktuell ein sehr intensiv bearbeitetes Forschungsthema. In dieser {\"U}bersichtsarbeit werden Originalarbeiten und Metaanalysen zu diesem Thema zusammengefasst. Hierbei zeigt sich, dass die internetbasierte kognitive Verhaltenstherapie f{\"u}r Insomnie (KVT-I) bei Erwachsenen durchweg sehr effektiv ist mit allenfalls leicht geringeren Effektst{\"a}rken als die gleiche Behandlung mit physischer Pr{\"a}senz von Therapeuten und Patienten. Behandlungseffekte zeigen sich dabei auch f{\"u}r sekund{\"a}re Outcome-Parameter wie Depressivit{\"a}t, Angst, Fatigue und Lebensqualit{\"a}t. Hingegen lassen die Forschung zur Wirksamkeit der internetbasierten KVT‑I bei Erwachsenen mit komorbiden psychischen St{\"o}rungen oder k{\"o}rperlichen Erkrankungen sowie die Forschung zur Frage, wieviel Therapeutenkontakt in die Behandlung integriert werden sollte, anscheinend noch keine abschließenden Antworten zu. In diesen Bereichen scheint weitere Forschung notwendig zu sein scheint.}, language = {de} } @article{WeberDankerHopfeDoganSanderetal.2022, author = {Weber, Franziska C. and Danker-Hopfe, Heidi and Dogan-Sander, Ezgi and Frase, Lukas and Hansel, Anna and Mauche, Nicole and Mikutta, Christian and Nemeth, Diana and Richter, Kneginja and Schilling, Claudia and Sebestova, Martina and Spath, Marian M. and Nissen, Christoph and Wetter, Thomas C.}, title = {Restless Legs Syndrome Prevalence and Clinical Correlates Among Psychiatric Inpatients}, series = {Frontiers in Psychiatry}, volume = {13}, journal = {Frontiers in Psychiatry}, publisher = {Frontiers Media SA}, issn = {1664-0640}, doi = {10.3389/fpsyt.2022.846165}, pages = {15}, year = {2022}, abstract = {BackgroundThere are only limited reports on the prevalence of restless legs syndrome (RLS) in patients with psychiatric disorders. The present study aimed to evaluate the prevalence and clinical correlates in psychiatric inpatients in Germany and Switzerland.MethodsThis is a multicenter cross-sectional study of psychiatric inpatients with an age above 18 years that were diagnosed and evaluated face-to-face using the International RLS Study Group criteria (IRLSSG) and the International RLS severity scale (IRLS). In addition to sociodemographic and biometric data, sleep quality and mood were assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), the Epworth Sleepiness Scale (ESS), and the Patient Health Questionnaire (PHQ-9). In addition to univariate statistics used to describe and statistically analyze differences in variables of interest between patients with and without RLS, a logistic model was employed to identify predictors for the occurrence of RLS.ResultsThe prevalence of RLS in a sample of 317 psychiatric inpatients was 16.4\%, and 76.9\% of these were diagnosed with RLS for the first time. RLS severity was moderate to severe (IRLS ± SD: 20.3 ± 8.4). The prevalences in women (p = 0.0036) and in first-degree relatives with RLS (p = 0.0108) as well as the body mass index (BMI, p = 0.0161) were significantly higher among patients with RLS, while alcohol consumption was significantly lower in the RLS group. With the exception of atypical antipsychotics, treatment with psychotropic drugs was not associated with RLS symptoms. Regarding subjective sleep quality and mood, scores of the PSQI (p = 0.0007), ISI (p = 0.0003), and ESS (p = 0.0005) were higher in patients with RLS, while PHQ-9 scores were not different. A logistic regression analysis identified gender (OR 2.67; 95\% CI [1.25; 5.72]), first-degree relatives with RLS (OR 3.29; 95\% CI [1.11; 9.73], ESS score (OR 1.09; 95\% CI [1.01; 1.17]), and rare alcohol consumption (OR 0.45; 95\% CI [0.22; 0.94] as predictors for RLS.ConclusionsClinically significant RLS had a high prevalence in psychiatric patients. RLS was associated with higher BMI, impaired sleep quality, and lower alcohol consumption. A systematic assessment of restless legs symptoms might contribute to improve the treatment of psychiatric patients.}, language = {en} }